Skeletal muscle cramps are a frequent and troublesome complication of hemodialysis. Standard treatment includes the intravenous injection of hypertonic saline, mannitol or calcium chloride. mannitol appears to be most effective in treating cramps. In addition, it was noted parenthetically in one study that prophylactic intravenous infusion of mannitol during hemodialysis reduced cramping by almost 50%. Despite this evidence, mannitol is used sparingly in this group of patients because of concerns about its potentially long half-life.